Department of Psychiatry (Child and Adolescent Psychiatry), Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA; Cystic Fibrosis Program, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Department of Psychiatry (Child and Adolescent Psychiatry), Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
J Cyst Fibros. 2018 Mar;17(2):276-280. doi: 10.1016/j.jcf.2017.08.011. Epub 2017 Sep 1.
International guidelines recommend depression and anxiety screening in individuals with cystic fibrosis (CF), but Attention-Deficit Hyperactivity Disorder (ADHD) remains understudied.
Adults with CF (n=53) were screened using the Adult ADHD Self-Report Scale-v1.1 Symptom Checklist (ASRS-v1.1), Cystic Fibrosis Questionnaire-Revised (CFQ-R), and a self-report measure of treatment adherence.
Elevated ADHD symptoms on the ASRS-v1.1 screener were reported by 15% of participants. Self-reported adherence, Body Mass Index in kg/m (BMI), and Forced Expiratory Volume in 1 Second, Percent Predicted (FEV1%pred) did not differ between participants with vs. without elevated ADHD scores. Three CFQ-R scales, Physical Functioning, Role Functioning, and Respiratory Symptoms, were significantly lower in participants with elevated ADHD screens (unadjusted p<0.05). This difference remained statistically significant for the Role Functioning and Respiratory Symptoms scales following correction for multiple comparisons.
The highly specific screening tool ASRS-v1.1 can ascertain previously undetected ADHD symptoms in adults with CF. ADHD was substantially more prevalent than expected in this population. Elevated ASRS-v1.1 screens correlated with poorer Health-Related Quality of Life (HRQoL) in some domains, but not with BMI, FEV1%pred, or self-reported CF treatment adherence. Additional research will elucidate the impact of ADHD and its treatment on HRQoL, CF self-care and health outcomes.
国际指南建议对囊性纤维化 (CF) 患者进行抑郁和焦虑筛查，但对注意力缺陷多动障碍 (ADHD) 的研究仍较少。
使用成人 ADHD 自评量表-1.1 症状清单 (ASRS-v1.1)、囊性纤维化问卷修订版 (CFQ-R) 和自我报告的治疗依从性测量对 CF 成人患者（n=53）进行筛查。
15%的参与者报告 ASRS-v1.1 筛查器上存在 ADHD 症状升高。在 ADHD 评分升高的参与者和没有升高的参与者之间，自我报告的依从性、体重指数 (kg/m，BMI) 和 1 秒用力呼气量占预计值的百分比 (FEV1%pred) 没有差异。有 ADHD 筛查升高的参与者在生理机能、角色机能和呼吸症状三个 CFQ-R 量表上的得分显著较低（未校正 p<0.05）。在进行多次比较校正后，角色机能和呼吸症状量表的差异仍具有统计学意义。
高度特异的 ASRS-v1.1 筛查工具可确定 CF 成人中以前未被发现的 ADHD 症状。ADHD 在该人群中的患病率明显高于预期。ASRS-v1.1 筛查升高与某些领域的健康相关生活质量 (HRQoL) 较差相关，但与 BMI、FEV1%pred 或自我报告的 CF 治疗依从性无关。进一步的研究将阐明 ADHD 及其治疗对 HRQoL、CF 自我护理和健康结果的影响。
